Neurology : In older people with epilepsy, the mortality rate is higher after 5 years

In adults, the risk of new epilepsy is greatest in patients over 70 years of age due to a variety of pathological mechanisms, including age-related vascular, degenerative and metabolic disorders.
, unlike all other age groups, the elderly population is growing rapidly and the incidence of epilepsy in this group is likely to increase.
as a result, the burden of epilepsy is likely to increase significantly over the next few years, making it necessary to provide large-scale character descriptions of epilepsy in older persons, including their relationship to mortality.
is well known that many chronic diseases have significant racial disparities in mortality.
this socio-demographic difference has been used to count and describe epilepsy-related mortality in young patients, but little is known about its presence in older people.
identify high-risk groups is critical to guiding clinical decision-making, as different treatment options can improve the prognostication of epilepsy and reduce mortality.
, of Mount Sinai School of Medicine in New York, and others used retrospective queue studies to study people 65 and older in 2009.
new cases of epilepsy were identified in 2009 using the ICD-9-CM coding algorithm (ICD-9-CM code-base algorithm); The mortality rate was assessed in 2014.
Cox regression model examined the relationship between five-year mortality and seizures, and whether mortality rates vary by socio-demographic characteristics or common diseases.
results show that in 2009, 99,990 of the 33,615,037 cases of confirmed epilepsy were among whites (79.7 per cent), women (57.3 per cent), cities (80.5 per cent) and 71.3 per cent without Medicaid.
diagnosed with epilepsy, the five-year mortality rate was 62.8% (62,838 deaths).
in the multivariable model, lower mortality rates were associated with female sex (adjusted risk ratio ahR s 0.85), Asian race (AHR s 0.82), and Hispanic race (AHR s 0.81).
the risk of death and the burden of co-sickness are associated with Medicaid co-insurance.
epilepsy is diagnosed, the mortality rate increases if combined with other neurological disorders: Parkinson's disease (AHR 1.29), multiple sclerosis (AHR 2.13), dementia (AHR 1.33), traumatic brain injury (AHR 1.55), stroke/TIA (AHR 1.20).
importance of this study is that newly diagnosed epilepsy patients are associated with mortality after five years.
, however, it is necessary for future studies to continue to explore the impact of underlying diseases, races, genders and poverty on mortality rates in people with epilepsy, thereby helping to design health-care systems to prevent premature deaths.
Blank, L. J., Acton, E. K., & Willis, A. W. (2020). Predictors of mortality in older adults with epilepsy: Implications for learning health systems. Neurology.<!--5f39ae17-8c62-4a45-bc43-b32064c9388a: W3siYmxvY2tJZCI6IjEzODgtMTYwOTM2NTczMTk5OCIsImJsb2NrVHlwZSI6InBhcmFncmFwaCIsInN0eWxlcyI6eyJhbGlnbiI6ImxlZnQiLCJpbmRlbnQiOjAsInRleHQtaW5kZW50IjowLCJsaW5lLWhlaWdodCI6MS43NSwiYmFjay1jb2xvciI6IiIsInBhZGRpbmciOiIifSwidHlwZSI6InBhcmFncmFwaCIsInJpY2hUZXh0Ijp7ImRhdGEiOlt7ImNoYXIiOiJOIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6ImUiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoidSIsInN0eWxlcyI6e yJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiJvIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6ImwiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoibyIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiJnIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6InkiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoiXyIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYX IiOiLogIEiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoi5bm0Iiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6IueZqyIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiLnl6siLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoi5oKjIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6IuiAhSIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiLvvIwiLCJzdHlsZXMiOns iYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoiNSIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiLlubQiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoi5ZCOIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19LHsiY2hhciI6IueahCIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiLmrbsiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoi5LqhIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZm In19LHsiY2hhciI6IueOhyIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fSx7ImNoYXIiOiLmm7QiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX0seyJjaGFyIjoi6auYIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19XSwiaXNSaWNoVGV4dCI6dHJ1ZSwia2VlcExpbmVCcmVhayI6dHJ1ZX19LHsiYmxvY2tJZCI6IjU5NTAtMTYwOTM2NzU2MzQ1NSIsImJsb2NrVHlwZSI6InBhcmFncmFwaCIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiIiwiYWxpZ24iOiJsZWZ0IiwiaW5kZW50IjowLCJ0ZXh0LWluZGVud CI6MCwibGluZS1oZWlnaHQiOjEuNzUsInBhZGRpbmciOiIifSwidHlwZSI6InBhcmFncmFwaCIsInJpY2hUZXh0Ijp7ImRhdGEiOlt7ImNoYXIiOiLCoCIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fV0sImlzUmljaFRleHQiOnRydWUsImtlZXBMaW5lQnJlYWsiOnRydWV9fSx7ImJsb2NrSWQiOiI5NTM3LTE2MDkzNjc1NjM0NTYiLCJibG9ja1R5cGUiOiJwYXJhZ3JhcGgiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiIsImFsaWduIjoibGVmdCIsImluZGVudCI6MCwidGV4dC1pbmRlbnQiOjAsImxpbmUtaGVpZ2h0IjoxLjc1LCJwYW RkaW5nIjoiIn0sInR5cGUiOiJwYXJhZ3JhcGgiLCJyaWNoVGV4dCI6eyJkYXRhIjpbeyJjaGFyIjoiwqAiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiNmZmZmZmYifX1dLCJpc1JpY2hUZXh0Ijp0cnVlLCJrZWVwTGluZUJyZWFrIjp0cnVlfX0seyJibG9ja0lkIjoiMTA2NS0xNjA5MzY3NTYzNDU3IiwiYmxvY2tUeXBlIjoicGFyYWdyYXBoIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIiLCJhbGlnbiI6ImxlZnQiLCJpbmRlbnQiOjAsInRleHQtaW5kZW50IjowLCJsaW5lLWhlaWdodCI6MS43NSwicGFkZGluZyI6IiJ9LCJ0eXBlIjoicGFyYWdyYXB oIiwicmljaFRleHQiOnsiZGF0YSI6W3siY2hhciI6IsKgIiwic3R5bGVzIjp7ImJhY2stY29sb3IiOiIjZmZmZmZmIn19XSwiaXNSaWNoVGV4dCI6dHJ1ZSwia2VlcExpbmVCcmVhayI6dHJ1ZX19LHsiYmxvY2tJZCI6IjIzODItMTYwOTM2NzU2MzQ1OCIsImJsb2NrVHlwZSI6InBhcmFncmFwaCIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiIiwiYWxpZ24iOiJsZWZ0IiwiaW5kZW50IjowLCJ0ZXh0LWluZGVudCI6MCwibGluZS1oZWlnaHQiOjEuNzUsInBhZGRpbmciOiIifSwidHlwZSI6InBhcmFncmFwaCIsInJpY2hUZXh0Ijp7ImRhdGEiOlt7ImNo YXIiOiLCoCIsInN0eWxlcyI6eyJiYWNrLWNvbG9yIjoiI2ZmZmZmZiJ9fV0sImlzUmljaFRleHQiOnRydWUsImtlZXBMaW5lQnJlYWsiOnRydWV9fSx7ImJsb2NrSWQiOiI0MzY0LTE2MDkzNjc1NjM0NTkiLCJibG9ja1R5cGUiOiJwYXJhZ3JhcGgiLCJzdHlsZXMiOnsiYmFjay1jb2xvciI6IiIsImFsaWduIjoibGVmdCIsImluZGVudCI6MCwidGV4dC1pbmRlbnQiOjAsImxpbmUtaGVpZ2h0IjoxLjc1LCJwYWRkaW5nIjoiIn0sInR5cGUiOiJwYXJhZ3JhcG